HOSPITAL AUTHORITY OF LIBERTY COUNTY (NPI# 1023443801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023443801 |
| Entity Type | Organization |
| Organization Name | HOSPITAL AUTHORITY OF LIBERTY COUNTY |
| Other Organization Name | COASTAL MANOR DAYBREAK |
| Practice Address |
128 Coastal Manor Dr Se Ludowici GA 31316-2951 |
| Practice Telephone | 9125453392 |
| Practice Fax Number | 9125453397 |
| Mailing Telephone | 9125453392 |
| Mailing Fax Number | 9125453397 |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2016-08-02 |
| Authorized Official Name | MR. MICHAEL S HESTER (CEO) |
| Authorized Official Telephone | 9123699400 |
| Is Organization Subpart | Y |
| Parent Organization Name | HOSPITAL AUTHORITY OF LIBERTY COUNTY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Coastal Manor Daybreak | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508356395 | Hospital Authority of Liberty County | Obstetrics & Gynecology | 455 S Main St Ste 202, Hinesville, GA 31313-4354 | 2018-05-16 |
| 1013267202 | Hospital Authority of Liberty County | Pediatrics | 455 S.main Street Ste 105, Hinesville, GA 31313 | 2012-09-14 |
| 1356636534 | Hospital Authority of Liberty County | Family Medicine | 455 S.main Street Ste 104, Hinesville, GA 31313 | 2011-06-15 |
| 1477875839 | Hospital Authority of Liberty County | Internal Medicine | 455 S Main Street Suite 102, Hinesville, GA 31313 | 2010-02-25 |
| 1265463004 | Hospital Authority of Liberty County | Skilled Nursing Facility | Hwy 84 East, Ludowici, GA 31316 | 2006-07-06 |
| 1326079260 | Hospital Authority of Liberty County | General Acute Care Hospital | 462 E G Miles Parkway, Hinesville, GA 31313-4000 | 2006-07-06 |
| 1063903011 | Hospital Authority of Liberty County | Clinic/Center | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2018-05-25 |
| 1093214041 | Hospital Authority of Liberty County | General Practice | 586 Islands Highway, Midway, GA 31320 | 2018-02-06 |
| 1972028660 | Hospital Authority of Liberty County | General Practice | 73 Coastal Manor Dr, Ludowici, GA 31316 | 2017-08-03 |
| 1740516129 | Hospital Authority of Liberty County | Surgery | 455 S Main St Ste 105, Hinesville, GA 31313-4354 | 2009-10-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HOSPITAL AUTHORITY OF LIBERTY COUNTY | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 |
| Street Address |
128 COASTAL MANOR DR SE |
| City | LUDOWICI |
| State | GA |
| Zip Code | 31316-2951 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104450220 | Bruce Sidney Williams | Behavior Technician | 63 Fury Lane Ne, Ludowici, GA 31316 | 2020-02-27 |
| 1821529074 | Chelsey Guthrie | Registered Nurse | 584 N Macon Street, Ludowici, GA 31316 | 2017-03-21 |
| 1154664126 | Mary A. Lias | Registered Nurse | 118 N. Mcdonald St., Ludowici, GA 31316 | 2013-03-28 |
| 1669798989 | Cecilia B Ong | Specialist | 213 North Mcdonald Street, Suite A & B, Ludowici, GA 31316 | 2010-04-12 |
| 1528298668 | Long County Health Center | Clinic/Center | 40 E Cypress St, Bldg A, Ludowici, GA 31316 | 2009-07-23 |
| 1952584708 | Diversity Health Center Inc | Clinic/Center | 213 N Mcdonald St Ste A&b, Ludowici, GA 31316 | 2007-12-14 |
| 1922159615 | John-michael Nakles | Marriage & Family Therapist | 16 Residence Street, Ludowici, GA 31316 | 2007-01-16 |
| 1659428720 | Florence O Baggs | Nurse Practitioner | 73 Coastal Manor Dr, Ludowici, GA 31316 | 2007-01-04 |
| 1265463004 | Hospital Authority of Liberty County | Skilled Nursing Facility | Hwy 84 East, Ludowici, GA 31316 | 2006-07-06 |
| 1982196507 | Holli Bailey Eason | Nurse Practitioner | 213 N Mcdonald St Ste A&b, Ludowici, GA 31316 | 2018-05-30 |
| Find all providers in zip 31316 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481506 | Loving Hands Foundation Incorporated | Clinic/Center | 206 Union St, Lagrange, GA 30241-3343 | 2020-09-09 |
| 1356962443 | Southern Hospitality Adult Day Health Agency LLC | Clinic/Center | 3349 Northside Dr W, Statesboro, GA 30458-2178 | 2020-04-30 |
| 1497383038 | Sheryl Dornblaser | Clinic/Center | 1180 Mckendree Church Rd Ste 107, Lawrenceville, GA 30043-5207 | 2020-03-30 |
| 1720616386 | Rainbow Senior Care Home Inc | Clinic/Center | 4405 International Blvd Ste B101, Norcross, GA 30093-3013 | 2020-03-30 |
| 1932733201 | Perfect Care, Inc | Clinic/Center | 114 Sullivan Dr, Americus, GA 31709-5534 | 2020-02-26 |
| 1710524483 | Norman Graham | Clinic/Center | 125 Marquis Dr, Fayetteville, GA 30214-1566 | 2019-12-02 |
| 1548802937 | Serenity Adult Day Health, Inc | Clinic/Center | 95 Truman Rd, Hawkinsville, GA 31036-4643 | 2019-10-17 |
| 1134778749 | Marietta Seniors Club LLC | Clinic/Center | 748 Lawrence St Ne, Marietta, GA 30060-2144 | 2019-09-06 |
| 1629626445 | Wholecare Wellness LLC | Clinic/Center | 5390 Peachtree Industrial Blvd Ste 130, Norcross, GA 30071-1566 | 2019-08-27 |
| 1750936498 | Sec of Georgia Corp | Clinic/Center | 5522 New Peachtree Rd Ste 128, Atlanta, GA 30341-2544 | 2019-08-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.